<div class="grid_12">
<div class="box">
  <div class="header">
    <?php echo $this->html->image('icons/packs/fugue/16x16/shadeless/table-excel.png');?>
  <h3>Denuncia de Nacimiento</h3><span></span>
  </div>



<div class="content">
  <?php echo $this->Form->create('Denuncianacimiento'); ?>
                  <div class="_50">
                    <label>En Fecha</label>
                    <p>
                      <?php echo $this->Form->date('fecha_denuncia', array('id'=>'date')); ?>
                    </p>
                  </div>
                  <div class="_50">
                    <label>En el criadero</label>
                    <p>
                      <?php echo $this->Form->select('criadero_id', $criaderos); ?> 
                    </p>
                  </div>
                  <div class="_100">
                    <label># Cachorros</label>
                    <p>
                      <?php echo $this->Form->text('numero_cachorros', array('size' =>5)); ?>
                    </p>
                    
                  </div>
                  <div class="_50">

                    <label># Machos muertos</label>
                    <p>
                      <?php echo $this->Form->text('num_muertos_machos', array('size' => 5)); ?>
                    </p>
                  </div>
                  <div class="_50">
                    <label># Hembras muertas</label>
                    <p>
                     <?php echo $this->Form->text('num_muertos_hembras', array('size' => 5)); ?>
                    </p>
                    
                  </div>
                   <div class="_50">
                    <label># Machos vivos</label>
                    <p>
                     <?php echo $this->Form->text('num_vivos_machos', array('size' => 5)); ?>
                    </p>
                    
                  </div>
                   <div class="_50">
                     <label># Hembras vivas</label>
                    <p>
                     <?php echo $this->Form->text('num_vivos_hembras', array('size' => 5)); ?>
                    </p>
                   
                  </div>
                  <div class="_50">
                    <label># Machos sacrificados</label>
                    <p>
                     <?php echo $this->Form->text('num_sacrificados_machos', array('size' => 5)); ?>
                    </p>
                    
                  </div>
                   <div class="_50">
                    <label># Hembras sacrificadas</label>
                    <p>
                     <?php echo $this->Form->text('num_sacrificados_hembras', array('size' => 5)); ?>
                    </p>
                  </div>
                  <div class="_100">
                    <label>Por que</label>
                    <p>
                     <?php echo $this->Form->textarea('razon_sacrificio'); ?>
                    </p>
                    
                  </div>
                  <div class="_100">
                    <h2>Datos para corrobar KCB</h2>
                    <label>Lugar</label>
                    <p>
                     <?php echo $this->Form->text('lugar'); ?>
                    </p>
                  </div>
                  <div class="_50">
                    <label>Fecha</label>
                    <p>
                     <?php echo $this->Form->date('fecha', array('id' => 'date2')); ?>
                    </p>
                  </div>
                  <div class="_50">
                    <label>Recibo</label>
                    <p>
                     <?php echo $this->Form->text('recibo1'); ?>
                    </p>
                    <p>
                     <?php echo $this->Form->text('rsocio', array('placeholder' => "socio")); ?>
                    </p>
                    <p>
                     <?php echo $this->Form->text('rcriador', array('placeholder' => "criador")); ?>
                    </p>
                  </div>
                    <div class="_50">
                    <label>Sello Regional</label>
                    <p>
                     <?php echo $this->Form->checkbox('sello_regional') ?>
                    </p>
                  </div>
                   <div class="_50">
                    <label>Firma Prop. Hembra(Aclaraci&oacute;n de Firma)</label>
                    <p>
                     <?php echo $this->Form->checkbox('firma_prop_hembra') ?>
                    </p>
                  </div>
                   <div class="_50">
                    <label>Firma Recetor REGIONAL(Aclaraci&oacute;n de Firma)</label>
                    <p>
                     <?php echo $this->Form->checkbox('firma_recetor_regional') ?>
                    </p>
                  </div>
      
      </div>
      <div class="actions">
                  <div class="actions-left">
                    <input type="reset" value="Limpiar" />
                  </div>
                  <div class="actions-right">
                    <?php $options=array('Value'=>'Registrar')?>
                    <?php echo $this->Form->end($options);?>                    
                  </div>
                </div>
      
      </div>

</div>
